The first recorded human corneal transplant (keratoplasty) was performed in the mid-1800s. This intricate procedure has been greatly refined in the intervening centuries thanks to advances in medical understanding, technology, and technique.
These days, a qualified eye care specialist can choose from several types of transplant to help restore lost vision and effectively eliminate the pain related to corneal injury and disease.
Dr. Stephen Khachikian is a top-level ophthalmologist and corneal transplant specialist who sees patients at the Black Hills Regional Eye Institute in Rapid City, South Dakota. He’s happy to answer questions and provide an expert’s insight regarding corneal transplants.
Why would you need a corneal transplant?
The cornea is the dome-shaped outer surface of your eye that covers the pupil, iris, and fluid-filled chamber at the anterior (front) portion of your eye.
Consisting of five layers of specialized cells, the cornea is normally transparent and allows light to pass through while its curved shape bends (refracts) the light. This action plays a vital role in your ability to focus clearly on objects in your visual field.
Certain conditions or injuries can alter the shape of the cornea or cloud it to the point that your vision becomes significantly blurred.
Unfortunately, unlike simple refractive errors such as nearsightedness or farsightedness, visual loss due to corneal damage may not be correctable with traditional contact lenses or glasses.
Issues that affect the cornea’s ability to adequately refract light include:
- Keratoconus, which causes abnormal bulging of the cornea
- Extreme corneal thinning, often related to keratoconus
- Corneal tears or lacerations
- Scarring caused by infection or injury that clouds the cornea
- Swelling related to infections (e.g., herpes) or fluid buildup behind the cornea
- Painful corneal ulcers related to contact lens use, injury, or infection
- Complications related to previous eye surgery
Fuchs’ dystrophy and other inherited diseases can also damage or wear away layers of your cornea, which may cloud the cornea, distort your vision, and cause significant pain.
When prescription eye drops, custom contact lenses for keratoconus, or other conservative treatments fail to relieve your pain or adequately improve your vision, Dr. Khachikian may recommend a corneal transplant.
What types of corneal transplant are available?
The goal of a corneal transplant is to replace diseased or damaged tissue with healthy donor tissue that restores normal cornea function. There are several types of transplant available and your best option depends on the extent of the damage or the condition causing the problem.
For you, Dr. Khachikian may suggest a full-thickness transplant to remove and replace all five layers of the cornea or a partial-thickness procedure to remove either the outer or inner layers.
During a full-thickness transplant (penetrating keratoplasty), Dr. Khachikian uses a special instrument to cut through and remove the entire thickness of the cornea.
This small, disc-shaped area is replaced with healthy donor tissue that’s sutured in place. If compatible donor tissue isn’t available, he can replace your cornea with a prosthetic.
When appropriate, Dr. Khachikian may recommend a partial-thickness transplant such as an endothelial keratoplasty to remove and replace the diseased inner layers with donor material. During an anterior lamellar keratoplasty, he removes the outer/top layers of the cornea.
Dr. Khachikian also has significant expertise in advanced surgical procedures such as IntraLase®-enabled keratoplasty (IEK).
During IEK, he uses a laser and computer-aided technology to remove and replace the targeted corneal tissue. This approach helps ensure an exceptional fit and requires minimal stitching.
Will your vision return to normal following a corneal transplant?
Most corneal transplants are successful. Depending on the type of transplant you receive, however, it can take several weeks to months for complete healing and full visual benefits.
Dr. Khachikian may recommend stem cell therapy or other regenerative medicine techniques, often undertaken during your surgery, to help speed healing. You can also expect to use medicated eye drops to help prevent rejection of the donor tissue.
As with any surgery, it’s important to follow aftercare instructions carefully and follow up in the office as directed.
Don’t ignore your eye health! For more information about corneal transplant or any of the other services we offer, schedule a visit with Dr. Khachikian today.